Cardiovascular and Respiratory Health Effects of Fine Particulate Matters (PM2.5): A Review on Time Series Studies

Ambient air pollution remains one of the most important risk factors for health outcomes. In recent years, there has been a growing number of research linking particulate matter (PM) exposure with adverse health effects, especially on cardiovascular and respiratory systems. The objective of this review is to examine the range and nature of studies on time series analysis of health outcomes affected by PM2.5 across a broad research area. A literature search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping review framework through a strategic search of PubMed and ScienceDirect online databases for articles from January 2016 to January 2021. Articles were first screened by their titles and abstracts. Then two reviewers independently reviewed and evaluated the full text of the remaining articles for eligibility. Of the 407 potentially relevant studies, 138 articles were included for final analysis. There was an increasing trend in publications from 2016 to 2019 but a decreasing trend in the year 2020. Most studies were conducted in Eastern and South-Eastern Asia (69.6%), Europe and Northern America (14.5%) and Latin America and the Caribbean (8.7%), with the majority coming from high- and upper-middle-income countries (95.6%). The main methodology used was Generalized Additive Model (GAM) with Poisson distribution (74.6%). Morbidity was the most common health outcome studied (60.1%), with vulnerable groups (64.5%) often included. The association between PM2.5 and health effects was stronger for respiratory diseases compared to cardiovascular diseases. In short-term studies (less than 7 years), respiratory diseases showed higher risks compared to cardiovascular. However, in long-term studies (7 years and more), cardiovascular showed higher risks.